Tiffany Carlton said a voice told her what to do while she was detained in the Linn County jail in 2016. Using her fingers, she dug the eye out of its socket and flushed it down the toilet.
Rodney White/The Register

Plans to improve mental health system in Iowa should emphasize funding for law enforcement and providing health insurance

Tiffany Carlton gouged out her left eye. The Cedar Rapids woman said a voice told her to do it while she was detained in Linn County jail 21 months ago. Using her fingers, she dug the eye out of its socket and flushed it down the toilet. Her next memory is being taken on a gurney to the hospital.

A Des Moines Register editorial writer first met Carlton in 2012. She was an inmate at the Iowa Correctional Institution for Women in Mitchellville, serving time for theft related to her addiction to pain medication. She responded to our call for essays from young Iowa writers, and we published her piece about being incarcerated.

After she was released in May 2016, we published her essay about the gratitude she felt for corrections workers and programs that provided the help she needed to get on track. At the time she was in a halfway house, had been sober several years and was hopeful about the future.

A few weeks later, things went awry, she told an editorial writer recently. Still living in the halfway house, Carlton heard a voice and told a worker she felt suicidal and needed to go to the hospital.

“When I got there, the voice was still talking to me,” she said. After attacking a nurse, she was taken to jail, where she attacked a sleeping cellmate.

“They cracked the door and pepper sprayed me in my face. I banged my head into the wall until I knocked myself out. Then they put me in another room and the voice told me I was getting ready to be crucified. He commanded me to gouge my eye out.”

Linn County Sheriff Brian Gardner said the jail is not a mental health facility. It provides a minimal amount of mental health care and can take emergency measures when needed. “That’s all we’re equipped to do. And quite honestly, we’re sometimes hard-pressed to be able to do that,” he said.

Carlton underwent eye surgery and received a prosthetic eye at the University of Iowa. She remained in a medical observation facility for a few days and then returned to prison for several months.

She is now living in Cedar Rapids, taking medications and participating in therapy. She has not been hearing voices. She is telling her story because she wants others with mental health problems to get the help they need.

Iowa's elected officials can do a lot to help people like Carlton. Perhaps the most important thing: Stop trying to strip Iowans of health insurance.

Our Republican members of Congress, including Sen. Chuck Grassley and Rep. David Young, continue to support repealing Obamacare. This makes absolutely no sense, particularly as some of these same members talk about the need for adequate mental health services in response to gun violence. Health insurance pays for these services.

Obamacare helped thousands of Iowans obtain coverage, including many suffering from mental illness who were previously ineligible for Medicaid or did not work jobs offering employer-based plans.

Without health insurance, Carlton and other Iowans cannot get the medications and therapy they need.

Policymakers must also recognize our correctional facilities have become de facto mental health facilities. Law enforcement, jails and prisons need adequate resources to keep troubled inmates and workers safe. An Iowa woman suffering from mental health problems should not lose her left eye while she's incarcerated.

Hearing a voice no one else can hear

Tiffany Carlton first heard a voice she thought was Jesus about halfway through her incarceration at the Iowa Correctional Institution for Women. She felt like she was generally doing well and family had recently visited her in prison. Below is her description of the experience:

I came into my cell and I immediately heard a voice in my head telling me he was Jesus. Over a period of approximately 3 years, I heard this voice. He said he wanted me to come to heaven numerous times so we could be married. He talked me into breaking my razor and slitting my wrist. Another time I used my teeth to bite a tiny hole in the vein of my right wrist. Blood squirted out.

Next thing I know I was in an ambulance. When we got to the hospital, they gave me fluids and four stitches. I am grateful to be alive today.

I was paroled in March of 2016 while still hearing the voice. I simply told the psychiatrist I was talking to God. I went to a halfway house in Cedar Rapids and held a decent job. My mental illness was still an issue but only when I was alone so I seemed normal to everyone around me.

I know now that all along the voice was the devil. The devil, I believe, punished me because I was so close to God. Before I heard the voice, I organized and led Bible studies where we would read daily devotionals and I’d take prayer requests and pray for everybody. Life was blissful to me before being interrupted by a voice that coerced me into doing harmful things.

A doctor once told me that schizophrenia is hereditary. It’s hard to believe that, but I do have family with mental health issues, but not hearing voices. I pray I did not pass this down to my four boys. I’d rather like to believe that my situation was different and is now contained.